The present invention relates to a manipulating section for an endoscopic treatment instrument including a hollow, first member, and a second member inserted into and movable relative to the first hollow member.
A Menghini tissue collecting needle, which is used for a biopsy of the pancreas, the liver and other organ by being inserted into and removed from a treatment instrument insertion channel in an endoscope, is known as one of endoscopic treatment instruments.
FIG. 17 shows the distal end portion of the Menghini tissue collecting needle which comprises a rod-shaped needle shaft 10 having a pointed end 11 and a tissue retaining recess 12 formed in the lateral side of an area close to the needle end 11 and into which an excised tissue specimen is retained.
A cannula or outer sheath 20 is fitted over the needle shaft 10 to be capable of moving back and forth along the longitudinal axis and it has an annular blade 21 formed on the inner circumference of the tip for cutting off the tissue retained in the recess 12.
The Menghini tissue collecting needle is simply a combination of a needle shaft and a outer sheath and used after being passed into a rigid endoscope.
If the Menghini needle is to be used by passage through a treatment instrument insertion channel in a so-called xe2x80x9csoft endoscopexe2x80x9d having a flexible insertion portion, an extremely great frictional resistance is caused within the tortuous treatment instrument insertion channel, making it difficult to manipulate the needle shaft and the outer sheath so they can be moved back and forth by small amounts and independently of each other. Consequently, it has been impossible to collect a tissue specimen in a safe and rapid manner.
Japanese Patent Kokai Publication No. Hei. 9-103433 discloses another endoscopic treatment instrument having a hollow, outer sheath (19), a hollow piecing needle (20) inserted into the outer sheath, and a stylette or metal core (21) inserted into the piecing needle. In this instrument, a piecing section sliding section (10) of the outer sheath (19) can be fixed with respect to a piecing manipulating section (9) using a knob (15), the piecing needle (20) can not be fixed with respect to the manipulating section (9). Further, since the stylette (21) is fixed with respect to the piecing needle (20), the stylette (21) cannot be moved independently during endoscopic treatment.
That is, the outer sheath (19), the piecing needle (20) and the stylette (21) can not be moved independently of one another during endoscopic treatment.
This is very inconvenient. For example, if the outer sheath (19) is moved slightly forward or backward by loosing the knob (15) and moving the sliding section (10) of the outer sheath (19), the piecing needle (20) is also moved to undesirably be pieced into or removed from a mucosa layer. That is, the outer sheath (19) can not be moved while keeping the piecing needle (2) stationary.
This inconvenience is also encountered during endoscopic treatment with a high frequency instrument. A doctor wants to move an outer sheath alone while keeping a snare wire stationary during surgery for removing a polyp, but cannot do so readily with the available instrument.
An object of the present invention is to provide a manipulating section for an endoscopic treatment instrument, which can fix a hollow member and another member inserted into the hollow member independently.
Another object of the present invention to provide a manipulating section for an endoscopic treatment instrument, which can move a hollow member and another member inserted into hollow member independently.
Yet another object of the present invention to provide a manipulating section for an endoscopic treatment, which can permit movement of one of a hollow member and another member inserted into the hollow member while keeping the other stationary.
Still another object of the present invention is to provide a manipulating section for an endoscopic tissue collecting instrument that allows for safe and rapid collection of a tissue specimen irrespective of whether it is used with a rigid or soft endoscope.
Further another object of the present invention is to provide a manipulating section for an endoscopic treatment instrument in which not only an outer sheath or hollow member but also a member disposed inside the outer sheath or hollow member to be movable in the longitudinal direction can be fixed with respect to an endoscope independently of each other.
According to a first aspect of the present invention, there is provided a manipulating section for an endoscopic treatment instrument, which has the first and second holding members. The first holding member can hold an end of a hollow, first member and can be selectively fixed or movable with respect to an endoscope during use.
According to a second aspect of the present invention, a manipulating section of an endoscopic tissue collecting instrument is designed such that it can be fixed to or disengaged from the entrance of a treatment instrument insertion channel in an endoscope. The basal end portion of a needle shaft and that of an outer sheath can be moved back and forth in unison along the longitudinal axis or fixed. Either the basal end portion of the needle shaft or that of the outer sheath is adapted to be capable of moving along the longitudinal axis or being fixed relative to the other of the basal end of the outer sheath or that of the needle shaft. Because of this design, both the operation of piercing the needle tip into the tissue and that of cutting off the tissue specimen collected in the tissue retaining recess can conveniently be performed from the side closer to the operator and, hence, the manipulating section of the invention allows for safe and quick collection of a tissue specimen irrespective of whether the endoscopic tissue collecting instrument is used with a rigid or soft endoscope.
According to a third aspect of the present invention, a manipulating section for an endoscopic treatment instrument is designed such that the basal end of an outer sheath and that of a member inserted into and passed through the outer sheath can be moved back and forth or fixed independently of each other along a frame plate adapted to be fixed to or disengaged from the entrance of a treatment instrument insertion channel in an endoscope. Not only an operation for moving the member back and forth with the outer sheath be fixed, but also an operation for moving the outer sheath with the member be fixed, and operation for fixing both the outer sheath and the member can be conducted as desired, thereby enabling endoscopic treatment in a simple and speedy manner.
A manipulating section according to the present invention is preferably applied to an endoscopic treatment instrument including a hollow, first member and a second member inserted into and movable relative to the first hollow member. The manipulating section is preferably designed to have a first plate, a first holding member holding an end of the first hollow member, the first holding member being movable along the plate, and selectively fixed with respect to the plate, and a second holding member holding an end of the second member, the second retaining being movable along the plate, and selectively fixed with respect to the plate.
The manipulating section may further has a coupling section connecting the plate to a socket of an endoscope, the socket being located at an inlet of a treatment instrument insertion channel of the endoscope.
The manipulating section may further has a second plate movable along and selectively fixed with respect to the first plate, wherein the first holding member is movable along the second plate and selectively fixed onto the second plate, and the second holding member is fixed onto the second plate.
The manipulating section may further has a second plate through which the first holding member is movable along the plate, and selectively fixed with respect to the plate.
The treatment instrument, to which the manipulating section is applied, may further includes a hollow, third member such that the second member is inserted into and movable relative to the third member, and an end of the third member is fixedly coupled with respect to the plate.
The treatment instrument, to which the manipulating section is applied, may be designed such that the second member is hollow, and the treatment instrument further includes a third member inserted into and movable relative to the hollow, second member. In this case, it is preferable that the manipulating section further has a third holding member holding an end of the third member, the third holding member being movable along the plate, and selectively fixed with respect to the plate.
The treatment instrument, to which the manipulating section is applied, may be designed such that the first member includes an outer sheath, the second member includes a needle shaft, and the third member includes a guide tube.
The treatment instrument, to which the manipulating section is applied, may be designed such that the first member includes a guide tube, the second member includes an outer sheath, and the third member includes a needle shaft.
The treatment instrument, to which the manipulating section is applied, may be designed such that the first member includes an outer sheath, and the second member includes a snare wire.
The manipulating section is preferably designed such that the first holding member is located between the coupling section and the second holding member.
The present invention further provides a manipulating section for an endoscopic tissue collecting instrument having a needle shaft with a needle tip formed at a distal end thereof, and an outer sheath fitted over the needle shaft to be capable of moving back and forth along a longitudinal axis, one of the needle shaft and the outer sheath having a tissue retaining recess formed in a lateral side of an area close to the distal end and the other of the outer sheath and the needle shaft having a blade formed at the distal end to cut off a tissue retained in the recess. The manipulating section is designed such that: the manipulating section can be fixed to or disengaged from an entrance of a treatment instrument insertion channel in an endoscope; a basal end portion of the needle shaft and a basal end portion of the outer sheath can be moved back and forth in unison along the longitudinal axis or fixed; and one of the basal end portion of the needle shaft and the basal end portion of the outer sheath is adapted to be capable of moving along the longitudinal axis or being fixed relative to the other of the basal end portion of the outer sheath and the other of the needle shaft.
A slider plate may be provided in such a way that the one of the basal end portion of the needle shaft and the basal end portion of the outer sheath is engaged with the slider plate movably to be capable of moving along the longitudinal axis, and the other of the basal end portion of the outer sheath and the basal end portion of the needle shaft is fixed to the slider plate, and the slider plate is capable of moving back and forth or being fixed relative to a frame of the manipulating section.
Each of the needle shaft and the outer sheath may have flexibility.
The needle shaft and the outer sheath maybe passed through a guide tube over the entire length thereof, and a basal end of the guide tube may be brought into engagement in the manipulating section.
The present invention further provides a manipulating section for manipulating, from an operator side, an endoscopic treatment instrument having an outer sheath inserted into and passed through a treatment instrument insertion channel in an endoscope and adapted to be manipulated, from the operator side, to be moved back and forth along a longitudinal axis, and an elongating member disposed within and passed through the outer sheath, and adapted to be manipulated, from the operator side, to be moved back and forth along the longitudinal axis. The manipulating section includes: a frame plate adapted to be fixed to or disengaged from an entrance of the treatment instrument insertion channel in the endoscope; an outer sheath lock nut by which a basal end portion of the outer sheath can be moved back and forth on an elongation of an axis of the entrance of the treatment instrument insertion channel along the frame plate or fixed; and an elongating member lock nut by which a basal end portion of the elongating member can be moved back and forth on the elongation of the axis of the entrance of the treatment instrument insertion channel along the frame plate or fixed.
A guide tube may be provided, which is inserted into and passed through the treatment instrument insertion channel in the endoscope, the outer sheath being inserted into and passed through the guide tube.
The manipulating section may further include: a guide tube lock nut by which a basal end portion of the guide tube can be moved back and forth on the elongation of the axis of the entrance of the treatment instrument insertion channel along the frame plate or fixed.
The present disclosure relates to the subject matter contained in Japanese patent application Nos. Hei. 11-353838 (filed on Dec. 14, 1999), and Hei. 11-355304 (filed on Dec. 15, 2000), which are expressly incorporated herein by reference in their entireties.